77 Questions
What is the main focus of Week 61 Dr. Deepak Manhas' discussion?
Abnormalities in fetal-neonatal transition
In the neonatal period, what physiological event is critical for a smooth transition to extrauterine life?
Maintenance of glucose homeostasis
What is the importance of defining hypoglycemia and hyperbilirubinemia in neonates?
To understand normal neonatal physiology
Untreated hypoglycemia and hyperbilirubinemia in neonates can lead to:
Neurodevelopmental delays
What should healthcare professionals be able to do after discussing hypoglycemia and hyperbilirubinemia?
Identify signs of these conditions in newborns
Why is it necessary to discuss the management plans for neonatal hypoglycemia and hyperbilirubinemia?
To ensure timely interventions for newborns
What role does identifying abnormalities in transition play in neonatal care?
It guides effective treatment strategies
True or False: Neonatal Hypoglycemia is a common physiological event that occurs in most newborns.
False
What type of light is most effective in phototherapy for neonatal jaundice?
Blue-green light (460-490 nm)
What is generated when normal bilirubin absorbs light during phototherapy?
Photooxidation products
How are configurational and structural isomers excreted from the body?
Excreted in bile without glucuronidation in the liver
What treatment is recommended for severe neonatal jaundice?
Exchange transfusion
What are potential complications of exchange transfusion?
Heart & lung problems
Which factor can influence the severity of neonatal jaundice according to the text?
Age and/or weight
What causes erroneously low bilirubin levels in samples sitting in sunlight before processing?
Sunlight causes the breakdown of bilirubin
What is the main excretion route for photooxidation products?
Mainly in urine
What is the main source of energy for cerebral cells?
Glucose
Which hormone is associated with excessive insulin production and is a risk factor for neonatal hypoglycemia?
Insulin
What is the role of GLUT1 and GLUT3 in glucose supply to the brain?
GLUT1 and GLUT3 transport glucose into the brain
What are common neurogenic symptoms associated with hypoglycemia in neonates?
Jitteriness, irritability, and tachypnea
What is a characteristic of glucose levels in breastfed term neonates compared to formula-fed neonates?
Lower glucose levels but higher ketone levels
Which of the following is NOT a risk factor for neonatal hypoglycemia?
Excessive ketogenesis
What are potential symptoms of hypoglycemia beyond poor suck and seizures in neonates?
High pitched cry and cyanosis
Which enzyme defect can lead to unconjugated hyperbilirubinemia in neonates?
Glucuronyl transferase deficiency
What is a common cause of bleeding-related RBC hemolysis leading to hyperbilirubinemia in neonates?
Blood group incompatibility
Which condition is characterized by dark/hyperpigmented urine and pale/acholic stools in neonates?
Biliary atresia
What is the primary effect of breast milk on the liver enzyme required for bilirubin metabolism?
Inhibits Glucuronyl transferase
Which syndrome is characterized by a total lack of glucuronyl transferase?
Crigler-Najjar syndrome type 1
Which factor increases the risk of kernicterus in neonates?
Asphyxia
What should be done if a neonate presents with jaundice at more than 2 weeks of age?
Order a bilirubin test for conjugated hyperbilirubinemia and rule out biliary atresia
What was the primary discovery related to the use of phototherapy for jaundice in neonates?
'Phototherapy was discovered accidentally at Rochford Hospital'
Which of the following is NOT a symptom of severe hypoglycemia in infants?
Jaundice
What is the primary risk associated with visible jaundice before discharge at any age?
Severe hyperbilirubinemia
What is the primary physiological effect of unconjugated bilirubin in neonates?
Neurotoxicity
Which statement accurately describes the progression of visible jaundice due to hyperbilirubinemia?
Progresses from head to toes/soles
What is the main reason for administering dextrose gel as a management strategy in infants with hypoglycemia?
To raise blood glucose levels
What is the potential consequence of pathological hyperbilirubinemia in neonates if left untreated?
Seizures
Which of the following is NOT a risk factor for hyperbilirubinemia in neonates?
Full-term gestation
How does unconjugated bilirubin differ from conjugated bilirubin in terms of neurotoxicity?
Unconjugated bilirubin can cross the blood-brain barrier and is neurotoxic.
What is the importance of maintaining glucose homeostasis for neonates?
Ensures a smooth transition to extrauterine life
Which event is critical for a smooth transition to extrauterine life in neonates?
Maintenance of glucose homeostasis
What can untreated hypoglycemia and hyperbilirubinemia lead to in neonates?
Long-term complications
What is the primary physiological effect of unconjugated bilirubin in neonates?
Neurotoxicity
Which factor influences the severity of neonatal jaundice?
Gestational age
Why is it crucial to identify abnormalities in transition in neonatal care?
To correlate with potential diseases
What are the potential complications of untreated hypoglycemia and hyperbilirubinemia in neonates?
Increased risk of long-term consequences
What are some signs that a neonate may present with if experiencing hypoglycemia or hyperbilirubinemia?
Hypotonia and poor feeding
What is the main source of energy for the cerebral cells?
Glucose
During the 1st hour of life, what metabolic shift occurs in terms of energy utilization?
Shift from glucose to a significant contribution by fat
Which neonates have lower glucose levels but higher ketone levels compared to formula-fed neonates?
Small for gestational age (SGA) infants
Which condition may present with poor suck, poor feeding, and seizures in neonates?
Hypoglycemia
What is the primary factor that increases the risk of neonatal hypoglycemia according to the text?
Excessive insulin production
What is the recommended blood glucose level threshold for starting enteral supplementation in asymptomatic infants?
< 2.5 mmol/L
What medical syndrome characterized by dark urine and pale stools can lead to neonatal hypoglycemia?
Galactosemia
Why are breastfed term neonates able to tolerate lower glucose levels without clinical manifestations compared to formula-fed infants?
Increased reliance on ketones as an energy source
What are the potential long-term neurological outcomes associated with neonatal hypoglycemia?
Learning disabilities and seizure disorders
How does physiological hyperbilirubinemia differ from pathological hyperbilirubinemia?
Age of onset
Which physiological process contributes to the risk of pathological hyperbilirubinemia in neonates?
Increased RBC mass
What is the primary source of energy for cerebral cells in neonates?
Glucose
Which factor is NOT associated with an increased risk of neonatal hypoglycemia?
Previous sibling with severe hyperbilirubinemia
What is the role of unconjugated bilirubin in terms of its neurotoxicity?
Crosses the blood-brain barrier and is neurotoxic
Which enzyme defect can lead to unconjugated hyperbilirubinemia in neonates?
Glucuronyl transferase
How does late preterm status relate to the risk of hypoglycemia in neonates?
< 38 wks gestation increases the risk of severe hypoglycemia
What is the primary cause of unconjugated hyperbilirubinemia in neonates due to an inadequate breast milk supply?
Enzyme defect
Which condition is characterized by a partial deficiency of glucuronyl transferase in neonates?
Crigler-Najjar syndrome type 2
What anatomical abnormality in neonates should never be missed as it greatly affects survival if operated on early?
Biliary atresia
Which enzyme deficiency can lead to conjugated hyperbilirubinemia in neonates?
Glucuronyl transferase
What is the main reason behind unconjugated hyperbilirubinemia in neonates with spherocytosis or elliptocytosis?
Hemoglobin defect
Which factor can cause an increased risk for kernicterus in neonates?
Toxic sepsis
What can cause Cconjugated Hyperbilirubinemia in neonates due to Anatomical abnormalities?
BILIARY ATRESIA
What enzyme defect can cause unconjugated hyperbilirubinemia in neonates with Asian males?
G6PD
What is the most effective type of light used in phototherapy for neonatal jaundice?
Blue-green light
How are configurational and structural isomers excreted from the body?
In bile without glucorinidation in the liver
What is the process involved in an exchange transfusion for neonates?
Slowly removing the baby's blood and replacing it with fresh donor blood
What is a common complication associated with exchange transfusion in neonates?
Blood clots
What is the main consequence of pathological hyperbilirubinemia in neonates if left untreated?
Brain damage (kernicterus)
What are some complications associated with severe neonatal jaundice that may require treatment beyond phototherapy?
Hyper-/hypo-kalemia, hypocalcemia, and abnormal acid-base balance
Learn about the association of hypoglycemia in infants with neurological outcomes such as learning disabilities, cerebral palsy, seizure disorders, visual impairment, and neurodevelopmental delay. Recognize the importance of immediate testing for hypoglycemia in symptomatic infants.
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